After completing this brief questionnaire, more detailed information will be provided to you before you decide if you would like to take part in the research. This questionnaire will be used only for the purpose of determining
your eligibility for this study. Before you begin, it’s important to know that your participation is entirely
voluntary and there is no cost or payment for participating. You will also have the opportunity to speak with and
ask questions to a member of the study team. Please be informed that you can stop this discussion at any time.
If you agree to participate in this questionnaire, you will be asked detailed information about your medical history, psychiatric history, and current psychiatric state. Please also note that by completing this questionnaire, you are consenting to BuildClinical to collect your answers to the questions, including your contact information. Information you provide about yourself will be kept as confidential as possible as required by law. Information you provide will only be shared with the research team conducting the study and will be stored on a secured Stanford server. BuildClinical will delete your information from our records upon your request.
The risk in taking part in this interview is very small. It’s possible that some people may feel uncomfortable answering these questions. The information will be kept confidential as noted, but there is a small risk that people outside of the research team could learn this information. The benefit to you is that you will find out whether you can take part in the screening session for our study. Following completion of the questionnaire, if you do not qualify for our study at this time, you may choose to allow us to contact you about future studies. If you have any questions, concerns, or complaints, please feel free to let the study team know, and we can give you the contact information of the principal investigator for this study. If you would like general information about your participant rights from someone independent of the study team, you can contact the Stanford Institutional Review Board at 1-866-680-2906.
If you agree to participate in this questionnaire, you will be asked detailed information about your medical history, psychiatric history, and current psychiatric state. Please also note that by completing this questionnaire, you are consenting to BuildClinical to collect your answers to the questions, including your contact information. Information you provide about yourself will be kept as confidential as possible as required by law. Information you provide will only be shared with the research team conducting the study and will be stored on a secured Stanford server. BuildClinical will delete your information from our records upon your request.
The risk in taking part in this interview is very small. It’s possible that some people may feel uncomfortable answering these questions. The information will be kept confidential as noted, but there is a small risk that people outside of the research team could learn this information. The benefit to you is that you will find out whether you can take part in the screening session for our study. Following completion of the questionnaire, if you do not qualify for our study at this time, you may choose to allow us to contact you about future studies. If you have any questions, concerns, or complaints, please feel free to let the study team know, and we can give you the contact information of the principal investigator for this study. If you would like general information about your participant rights from someone independent of the study team, you can contact the Stanford Institutional Review Board at 1-866-680-2906.
